Incidental anorectal pathologic findings in prostatic needle core biopsies: A 13-year experience from a genitourinary pathology consult service

Research output: Contribution to journalArticle

Abstract

Fragments of anorectal mucosa are frequently present in transrectal prostate core biopsy specimens. Pathologic findings within the anorectal mucosa are easily overlooked, in part because of their rarity and because anorectal mucosa is not the focus of examination. We reviewed pathologic reports of 96-656 prostate biopsies diagnosed in our consultation service from 1997 to 2010. Anorectal lesions were detected in 30 cases, which were summarized as follows: (1) Neoplasia and polyps (n = 10). A flat rectal adenoma with high-grade dysplasia was identified, for which the patient received hemicolectomy. One patient was found to have a rectal carcinoid tumor. Other neoplastic findings included 1 with low-grade B-cell lymphoma, 3 with hyperplastic polyps, 3 with tubular adenomas, and 1 with anal mucosa with high-grade dysplasia that was found to be a contaminant from another case. (2) Inflammatory changes (n = 20). Acute proctitis was found in 12 patients, including 1 with acute radiation proctitis, 2 with inflammatory bowel disease, and 9 with nonspecific proctitis probably due to bowel preparation. Pulse granulomas and nonnecrotizing granulomas were seen in 5 patients, including 3 with diverticular disease, 1 with history of perirectal fistula, and 1 with unknown etiology. Three patients had miscellaneous findings including muciphage reaction, increased eosinophils, and features of collagenous colitis. In conclusion, it is exceedingly rare to find significant pathology in the rectal fragments associated with prostate needle biopsies. Nevertheless, pathologists should evaluate the rectal mucosa for both neoplastic and inflammatory changes to avoid missing clinically significant anorectal diseases.

Original languageEnglish (US)
Pages (from-to)1674-1681
Number of pages8
JournalHuman Pathology
Volume41
Issue number12
DOIs
StatePublished - Dec 2010

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Large-Core Needle Biopsy
Proctitis
Mucous Membrane
Pathology
Prostate
Polyps
Granuloma
Adenoma
Rectal Diseases
Collagenous Colitis
Biopsy
Carcinoid Tumor
Needle Biopsy
B-Cell Lymphoma
Rectal Neoplasms
Eosinophils
Non-Hodgkin's Lymphoma
Fistula
Referral and Consultation
Radiation

Keywords

  • Anorectal mucosa
  • Inflammatory
  • Neoplastic
  • Prostate biopsy

ASJC Scopus subject areas

  • Pathology and Forensic Medicine

Cite this

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title = "Incidental anorectal pathologic findings in prostatic needle core biopsies: A 13-year experience from a genitourinary pathology consult service",
abstract = "Fragments of anorectal mucosa are frequently present in transrectal prostate core biopsy specimens. Pathologic findings within the anorectal mucosa are easily overlooked, in part because of their rarity and because anorectal mucosa is not the focus of examination. We reviewed pathologic reports of 96-656 prostate biopsies diagnosed in our consultation service from 1997 to 2010. Anorectal lesions were detected in 30 cases, which were summarized as follows: (1) Neoplasia and polyps (n = 10). A flat rectal adenoma with high-grade dysplasia was identified, for which the patient received hemicolectomy. One patient was found to have a rectal carcinoid tumor. Other neoplastic findings included 1 with low-grade B-cell lymphoma, 3 with hyperplastic polyps, 3 with tubular adenomas, and 1 with anal mucosa with high-grade dysplasia that was found to be a contaminant from another case. (2) Inflammatory changes (n = 20). Acute proctitis was found in 12 patients, including 1 with acute radiation proctitis, 2 with inflammatory bowel disease, and 9 with nonspecific proctitis probably due to bowel preparation. Pulse granulomas and nonnecrotizing granulomas were seen in 5 patients, including 3 with diverticular disease, 1 with history of perirectal fistula, and 1 with unknown etiology. Three patients had miscellaneous findings including muciphage reaction, increased eosinophils, and features of collagenous colitis. In conclusion, it is exceedingly rare to find significant pathology in the rectal fragments associated with prostate needle biopsies. Nevertheless, pathologists should evaluate the rectal mucosa for both neoplastic and inflammatory changes to avoid missing clinically significant anorectal diseases.",
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T2 - A 13-year experience from a genitourinary pathology consult service

AU - Ye, Huihui

AU - Montgomery, Elizabeth A

AU - Epstein, Jonathan Ira

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N2 - Fragments of anorectal mucosa are frequently present in transrectal prostate core biopsy specimens. Pathologic findings within the anorectal mucosa are easily overlooked, in part because of their rarity and because anorectal mucosa is not the focus of examination. We reviewed pathologic reports of 96-656 prostate biopsies diagnosed in our consultation service from 1997 to 2010. Anorectal lesions were detected in 30 cases, which were summarized as follows: (1) Neoplasia and polyps (n = 10). A flat rectal adenoma with high-grade dysplasia was identified, for which the patient received hemicolectomy. One patient was found to have a rectal carcinoid tumor. Other neoplastic findings included 1 with low-grade B-cell lymphoma, 3 with hyperplastic polyps, 3 with tubular adenomas, and 1 with anal mucosa with high-grade dysplasia that was found to be a contaminant from another case. (2) Inflammatory changes (n = 20). Acute proctitis was found in 12 patients, including 1 with acute radiation proctitis, 2 with inflammatory bowel disease, and 9 with nonspecific proctitis probably due to bowel preparation. Pulse granulomas and nonnecrotizing granulomas were seen in 5 patients, including 3 with diverticular disease, 1 with history of perirectal fistula, and 1 with unknown etiology. Three patients had miscellaneous findings including muciphage reaction, increased eosinophils, and features of collagenous colitis. In conclusion, it is exceedingly rare to find significant pathology in the rectal fragments associated with prostate needle biopsies. Nevertheless, pathologists should evaluate the rectal mucosa for both neoplastic and inflammatory changes to avoid missing clinically significant anorectal diseases.

AB - Fragments of anorectal mucosa are frequently present in transrectal prostate core biopsy specimens. Pathologic findings within the anorectal mucosa are easily overlooked, in part because of their rarity and because anorectal mucosa is not the focus of examination. We reviewed pathologic reports of 96-656 prostate biopsies diagnosed in our consultation service from 1997 to 2010. Anorectal lesions were detected in 30 cases, which were summarized as follows: (1) Neoplasia and polyps (n = 10). A flat rectal adenoma with high-grade dysplasia was identified, for which the patient received hemicolectomy. One patient was found to have a rectal carcinoid tumor. Other neoplastic findings included 1 with low-grade B-cell lymphoma, 3 with hyperplastic polyps, 3 with tubular adenomas, and 1 with anal mucosa with high-grade dysplasia that was found to be a contaminant from another case. (2) Inflammatory changes (n = 20). Acute proctitis was found in 12 patients, including 1 with acute radiation proctitis, 2 with inflammatory bowel disease, and 9 with nonspecific proctitis probably due to bowel preparation. Pulse granulomas and nonnecrotizing granulomas were seen in 5 patients, including 3 with diverticular disease, 1 with history of perirectal fistula, and 1 with unknown etiology. Three patients had miscellaneous findings including muciphage reaction, increased eosinophils, and features of collagenous colitis. In conclusion, it is exceedingly rare to find significant pathology in the rectal fragments associated with prostate needle biopsies. Nevertheless, pathologists should evaluate the rectal mucosa for both neoplastic and inflammatory changes to avoid missing clinically significant anorectal diseases.

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